• 제목/요약/키워드: Clinical judgment

검색결과 119건 처리시간 0.03초

중년 여성의 식생활 중심 건강상태 판정 도구의 현장 적용 및 평가 (Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women)

  • 이혜진;이경혜
    • 대한지역사회영양학회지
    • /
    • 제23권4호
    • /
    • pp.277-288
    • /
    • 2018
  • Objectives: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. Methods: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value <0.05 was considered to be statistically significant. Results: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p<0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p<0.001). Conclusions: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

3-Tier 클라이언트/서버 모델 기반 스마트 뇌파케어시스템의 개발 (Development of Smart Brain-Wave Care System based on 3-Tier Client/Server Model)

  • 안민희;박병운;양해술
    • 한국산학기술학회논문지
    • /
    • 제10권9호
    • /
    • pp.2535-2544
    • /
    • 2009
  • 뇌파연구는 비교적 안전하게 뇌상태에 관한 다양한 정보를 제공한다. 상담자나 피검자는 뇌파의 측정, 분석, 관리 등 일련의 과정에 대해 편리하게 사용자 TCO를 절감할 수 있어야 하고, 원하는 정보에 실시간 접근이 가능해야 한다. 기존 환경이 전문가의 판단에 따른 수작업 형태였다면, 본 논문이 제안한 시스템은 3-Tier 클라이언트/서버 IT기 술 및 BQT를 포함하는 뇌파기술을 융합하고 최적화시킨 스마트 뇌파케어시스템이다. 이 시스템은 편리한 웹 인터페이스를 통해 전 과정을 완전히 자동화하여 실시간서비스를 실현하였다. 본 연구로 개발된 이 시스템은 현재, 필드에서 서비스를 진행하고 있으며, DB에 수집된 자료는 연구자들에게 임상연구의 용도로 제공되고 있다.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
    • /
    • 제64권7호
    • /
    • pp.313-321
    • /
    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

의사소통장애인의 조음치료를 위한 한국형 전자구개도의 구현 (Preliminary study of Korean Electro-palatography (EPG) for Articulation Treatment of Persons with Communication Disorders)

  • 우승탁;박영빈;오다희;하지완
    • 센서학회지
    • /
    • 제28권5호
    • /
    • pp.299-304
    • /
    • 2019
  • Recently, the development of rehabilitation medical technology has resulted in an increased interest in speech therapy equipment. In particular, research on articulation therapy for communication disorders is being actively conducted. Existing methods for the diagnosis and treatment of speech disorders have many limitations, such as traditional tactile perception tests and methods based on empirical judgment of speech therapists. Moreover, the position and tension of the tongue are key factors of speech disorders with regards to articulation. This is a very important factor in the distinction of Korean characters such as lax, fortis, and aspirated consonants. In this study, we proposed a Korean electropalatography (EPG) system to easily measure and monitor the position and tension of the tongue in articulation treatment and diagnosis. In the proposed EPG system, a sensor was fabricated using an AgCl electrode and biocompatible silicon. Furthermore, the measured signal was analyzed by implementing the bio-signal processing module and monitoring program. In particular, the bio-signal was measured by inserting it into the palatal from an experimental control group. As a result, it was confirmed that it could be applied to clinical treatment in speech therapy.

목 근육에 대한 근에너지기법 적용이 전방머리자세에 미치는 영향 (The Effect of Applying the Muscle Energy Technique to Neck Muscles on the Forward Head Posture)

  • 김현수;이건철;김대진;안정훈
    • 대한통합의학회지
    • /
    • 제9권1호
    • /
    • pp.173-181
    • /
    • 2021
  • Purpose : The purpose of this study is to compare muscle activity after applying two muscle energy techniques (MET) to subjects with forward head posture to see if the post isometric relaxation (PIR) technique is more effective than the reciprocal inhibition (RI) technique. Methods : The muscle activity was measured using EMG after applying the PIR and RI techniques to 30 adults at K College. Subjects were selected for forward head posture whose ear center was 2.5 ㎝ front of the center of the shoulder. EMG equipment was used to measure muscle activity, and the measurement sites were measured in cervical flexor and extensor muscles. The experiment period was performed once a week for a total of two weeks, and after the pre-measurement was performed for 5 minutes PIR and RI exercise. In the PIR technique, the head is tilted back in a sitting position, and the experimenter applies resistance with the same force for 7~10 seconds and repeats 3-5 times after rest. In the RI technique, in a sitting position, the subject gives the force to bend the head forward, and the experimenter applies resistance with the same force for 7 to 10 seconds, and repeats 3 to 5 times after rest. Results : The result is same as the following. In the comparison of muscle activity, there was a significant decrease in both PIR and RI at 1 and 2 weeks. And there was a greater decrease in muscle activity in PIR. There was no difference in the comparison of decrease in muscle activity at 1 week and 2 week. Conclusion : Both PRI and RI can be said to be effective in improving the function of the forward head posture in the neck muscles. Therefore, the selection of the two techniques in clinical practice should be appropriately performed under the judgment of experts according to the patient's situation.

한의사 의료기기 사용과 관련된 판례 및 기존 연구 분석과 경향 변화 (A Study on the Precedents Changing Related to Using Medical Devices of Korean Medicine Doctors)

  • 박정수;오기창;권상혁;추홍민;김정상
    • 대한한방내과학회지
    • /
    • 제42권6호
    • /
    • pp.1303-1318
    • /
    • 2021
  • Objectives: The aim of this study was to examine the debate on the use of medical devices between Western Medicine and Korean Medicine, as this is one of the greatest conflicts in Korea's medical profession. Judicial precedents and interpretations of authority serve as regulations because medical affairs law states that Korean Medicine practices are ambiguous. Method: We conducted a search in the Korean RISS, OASIS, and DBPIA databases using several keywords associated with medical devices, Korean Medicine, and Korean Medicine Doctors. The search period was until November 5 2021. The retrieved papers were classified according to the selection and exclusion criteria by checking the title, abstract, and text. For precedents, searches were done regarding comprehensive legal information, etc., and in the case of non-disclosure precedents, we requested access to the precedents by web-court requests. Results: A total of 80 documents were found as a result of the search, and 13 publications were included in the study. The selected publications were classified and analyzed by this research team into Korean medicine, Western medicine, and legal or state agency research. In the existing literature and judgments, the arguments that played a major role changed depending on the time the judgment was made. "Social conventions", "curriculum", "academic principles", and "health and hygiene dangers" were the key arguments. Conclusions: Further studies will be needed that can comprehensively arrange the existing literature and clinical results, and continuous study will be needed to verify that the use of medical devices by Korean medicine doctors is helpful for prognosis and accurate treatment of their patients.

A Comparative Analysis of Patient Satisfaction and Cosmetic Outcomes after Breast Reconstruction through BREAST-Q and the Judgment of Medical Panels: Does it Reflect Well in Terms of Aesthetics in Korean Patients?

  • Choi, Woo Jung;Song, Woo Jin;Kang, Sang Gue
    • Archives of Plastic Surgery
    • /
    • 제49권4호
    • /
    • pp.488-493
    • /
    • 2022
  • Background Currently, the BREAST-Q can effectively measure patient's satisfaction on the quality of life from the patient's perspective in relation to different type of breast reconstruction. However, evaluation of patient satisfaction and cosmetic outcomes in breast reconstruction may have potential to led bias. Methods To maximize the benefits of using BREAST-Q to evaluate clinical outcome, we performed comparative study focused on the correlation between postoperative BREAST-Q and cosmetic outcomes assessed by medical professionals. For the current analysis, we used three postoperative BREAST-Q scales (satisfaction with breast, psychosocial well-being, and sexual well-being). The Ten-Point Scale by Visser et al was applied to provide reproducible grading of the postoperative cosmetic outcomes of the breast. The system includes six subscales that measured overall aesthetic outcome, volume, shape, symmetry, scarring, and nipple-areolar complex. The photographic assessments were made by five medical professionals who were shown photographs on a computer screen in a random order. Obtained data were stored in Excel and evaluated by Spearman's correlations using SPSS Statistics. Results We enrolled 92 women in this study, 10 did not respond to all scales of postoperative BREAST-Q, the remaining 82 women had undergone breast reconstruction. The correlation between BREAST-Q score and aesthetic score measured by Ten-Point Scale for the three BREAST-Q scales all show positive values in Spearman's correlation coefficient. Conclusion A significant correlation without any bias observed was found between the patient's satisfaction measured by BREAST-Q after breast reconstruction and the medical expert's aesthetic evaluation.

흉부 X-ray 기반 의료영상 품질평가 보조 도구 개발 (Development of Medical Image Quality Assessment Tool Based on Chest X-ray)

  • 남기현;유동연;김양곤;선주성;이정원
    • 정보처리학회논문지:소프트웨어 및 데이터공학
    • /
    • 제12권6호
    • /
    • pp.243-250
    • /
    • 2023
  • 흉부 X-ray 영상은 폐와 심장을 검사하는 방사선 검사이며 특히, 폐 질환을 진단하는 데 널리 사용되고 있다. 이러한 흉부 X-ray의 품질은 의사의 진단에 영향을 줄 수 있으므로 품질을 평가하는 과정이 필수적으로 거쳐야 하는데, 이 과정은 영상의학과 전문의의 주관이 개입될 수 있고, 수작업으로 이루어지기 때문에 많은 시간과 비용이 소모된다. 또한, 이러한 품질평가는 X-ray 영상의 특징과 사용 목적에 따라 일반적인 품질평가와는 다른 평가 요소가 필요하다. 따라서 본 논문에서는 X-ray 영상에서 검출되는 장기의 해상도, ,해부학적인 구조, 균형 등을 고려하여 임상 현장에서 사용되는 흉부 X-ray 영상 화질 평가 가이드라인을 적용하여 품질요소를 5가지(인공음영, 포함범위, 환자자세, 흡기정도, 그리고 투과상태)로 나누고 이를 자동화하는 도구를 제안한다. 제안하는 도구는 수작업으로 품질평가를 진행하는 본래의 방식 대비 소요 시간과 비용을 줄여주고, 더 나아가 흉부 X-ray를 이용한 학습 모델 개발에 높은 품질의 학습데이터를 선별하는 과정에도 사용될 수 있다.

델파이조사를 통한 신규간호사 역량 도출 및 내용타당도 검증 (Development of Competencies for New Nurses and Verification of Content Validity through a Delphi Survey)

  • 정한나;이윤정;김정연;이민진;한수영;이유미;안신기;김필자
    • 의학교육논단
    • /
    • 제25권2호
    • /
    • pp.159-173
    • /
    • 2023
  • The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master's degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2-12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients' needs by improving the competency of new nurses and lowering the turnover rate.

The Role of Artificial Intelligence in Gastric Cancer: Surgical and Therapeutic Perspectives: A Comprehensive Review

  • JunHo Lee;Hanna Lee ;Jun-won Chung
    • Journal of Gastric Cancer
    • /
    • 제23권3호
    • /
    • pp.375-387
    • /
    • 2023
  • Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions. Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.